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April 18, 1986

The Removal of Central Venous Silicone Rubber Catheters

Author Affiliations

Colorado Springs. Colo

JAMA. 1986;255(15):2021-2022. doi:10.1001/jama.1986.03370150063010

To the Editor.—  Dr Fisher1 reports the spontaneous erosion of the Dacron cuff several months after an extraction of the Hickman catheter. I was pleased to see in his article the description of his technique of removal, as I have yet to see a Hickman catheter slip out of its Dacron cuff. The hazards of the catheter breaking between the exit side and the cuff during a traction effort could well facilitate an air embolus at the time of the breakage unless the catheter was guaranteed to be full of clotted blood.For this reason and particularly because of the totally innocuous procedure of cutting down on the Dacron cuff I find it hard to justify even trying to remove Hickmans by traction with the intent of leaving the Dacron cuff in the soft tissues.I would heartily endorse Dr Fisher's conclusion that in the future the catheter be